Oct 192012
 

Data from a University of Maryland School of Medicine survey were just released showing that nearly four out of ten lesbians do not get regular pap smears. Pap smears screen for cervical cancer, among other things. Cervical cancer is usually caused by the human papilloma virus (HPV). HPV can be spread by skin-to-skin contact, so lesbians are just as much at risk for getting HPV as bisexual or heterosexual women. Screening is important to detect precancerous changes and cancer in their earliest stages so that treatment can be done when it’s most effective, preventing deaths.

Why do so few lesbians get their screenings? The primary reasons cited in the survey were: a) not having a physician referral, and b) not having a physician. Together, these two reasons account for 34.8% of study participants. We already know that lack of access to care is a big problem in gender and sexual minority communities. This just helps to confirm it. The survey authors note that lesbians who were open with their physicians about their sexual orientation were more likely to be screened than those who weren’t open.

There has been a recent change to pap smear recommendations. Pap smears are no longer recommended every year for most people. Screening starts at 3 years after first sexual activity, or age 21, whichever is first. From age 21-30, screen every 3 years, then from age 30-65, screen and do an HPV test every 5 years. After 65, no screening is recommended. If a pap smear is abnormal, screenings become more frequent. I should also note that these guidelines apply to everyone with a cervix, regardless of gender identity.

I, personally, think it’s highly advisable for everyone to know their HPV status and get vaccinated if possible, in addition to regular pap smears. HPV vaccines are not a replacement for pap smears because they don’t vaccinate for all HPV strains which cause cervical cancer. However, vaccines do protect against some.

EDIT (10/21/2012): I should also note that during a pap smear, a physician can do other screenings. This includes gonorrhea/chlamydia screening, looking for signs of other STDs or vaginal cancer, and checking the ovaries for lumps.

Jan 102011
 

The HPV (human papillomavirus) vaccine Gardasil has just been approved for use in preventing anal cancer (Source). HPV is a sexually transmitted disease that causes genital warts and has been implicated in some cancers, including anal and cervical cancer. The majority of anal and cervical cancers are associated with HPV (Source).

HPV is common (around 50% of the US population has it) and difficult to control. HPV has a number of different strains. Some cause warts (including hand and genital warts), and some cause cancers (Source). It spreads by skin-to-skin contact, so any activity involving touching or licking genitals or anus can spread it. Barriers are useful in prevention, though not completely effective. As with all STIs, having few sexual partners is considered a preventative measure. Populations considered to be at high risk for HPV include men who have sex with men (presumably because of unprotected anal sex), people having anal sex, men who are not circumcised, and people with multiple partners (Source).

Gardasil is a three-shot series. It can’t grant immunity once a person’s been exposed to HPV, so it’s recommended for people who are not yet sexually active.

Anal cancer happens in both men and women, and is largely caused by HPV. Risk factors separate from the HPV-related ones include: smoking, having HIV, having a compromised immune system, and having anal sex (Source).

The FDA’s approval comes on the heels of a study showing that, in a high-risk population (men who have sex with men), Gardasil was shown to be 78% effective in preventing infection with the HPV strands that cause anal cancer (Source).

I think this is fabulous. More tools have definitely been needed in preventing HPV-related cancer. Anal cancer also seems to be something that’s rarely talked about, so I hope this will spur discussion. I certainly have further questions:

Resources and Sources:

Anal Cancer Overview

HPV Fact Sheet

FDA News Release

Wikipedia: HPV

Wikipedia: Anal cancer